Psychotic experiences ‘not always pathologic’

By Eleanor McDermid, Senior medwireNews Reporter

A study backs the existence of “healthy schizotypy,” in which psychotic experiences do not lead to mental illness.

Naomi Tabak and Amy Weisman de Mamani (University of Miami, Florida, USA) identified six schizotypy profiles from the responses of 420 students to the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE) questionnaire.

Some previous studies have identified three or four profiles. The researchers point out that one profile seemingly common to all studies is a subgroup of people with higher than average scores on the unusual experiences (UE) O-LIFE subscale, which measures subclinical positive psychotic experiences.

This profile, which applied to 30 people in the current study, is also that best fitting the theoretical notion of healthy schizotypy, says the team. Consistent with this notion, people with the high UE profile scored highly on all domains of the Quality of Life Inventory (QOLI) questionnaires except for environmental mastery. For the other domains, their scores were similar to those of the 140 people with low schizotypy (lower than average O-LIFE) scores and of the 161 people with average schizotypy (score close to average for the whole cohort).

“In line with the cognitive model of psychosis, the High UE group demonstrates that it may not be the anomalous experiences in and of themselves that are pathological, but one's cognitive interpretation of these aberrant experiences that differentiates between adaptive and pathological progression,” the researchers write in Psychiatry Research.

“In particular, one’s level of certainty in the appraisal of unusual experiences may be more salient in determining the psychopathological relevance of these experiences than their frequency.”

The other profiles were high schizotypy (six people), high introvertive anhedonia (40 people), and high introvertive anhedonia/cognitive disorganization (43 people). People in the latter group most often had the lowest QOLI scores.

“The association between the interpersonal dimension of schizotypy and well-being is consistent with previous evidence, which indicates that this domain is most closely associated with poor quality of life,” comment the researchers.

They suggest that future research should focus on how people with healthy schizotypy make sense of their unusual experiences. “This research may help broaden our understanding of adaptive cognitive interpretations of unusual experiences, which may be applied to the treatment of individuals in the early phases of psychosis.”

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